Family Relationships

Join other women in the sandwich generation - share ideas and solutions as you learn to nourish family relationships without starving yourself.

Thursday, September 17, 2009

Caregiving for Your Aging Parents

We want to welcome Barbara Friesner, founder of AgeWiseLiving and author of The Ultimate Caregiver’s Success Guide, to our Virtual Book Tour today. And readers, you're about to receive a lot of valuable information about caring for your aging parents. So let's get started:

Nourishing Relationships: Why did you write The Ultimate Caregiver’s Success Guide?

Barbara Friesner: Caregivers can learn all they want about what to do to resolve their eldercare issues – and there's plenty of stuff out there to read. (In fact, if you Google ‘eldercare’ over 4 million entries come up). But if you aren't shown exactly how to do it, you’re no better off. Plus, it made me really sad to see people struggle the way most eldercare providers do. That’s when I decided it was time to put my 25 years of caregiving and 10 years of Generational Coaching on paper.

N R: Your book comes with 11 CDs. Why is that?

B F: I wanted The Ultimate Caregiver’s Success Guide to be as easy to use as possible. But there was so much other information that’s vital to a caregiver’s success. So I created 6 CDs on topics, such as who your aging loved one is generationally, what they’re going through emotionally, 19 caregiver pitfalls and how to avoid them, etc; a CD of all the forms and worksheets in The Ultimate Caregiver’s Success Guide; a CD of my rolodex of outside resources; and 3 CD’s featuring the latest experts’ advice from an Elder Law Attorney; a Personal Financial Planner; and a Family Relationship Expert. Armed with all this information, a caregiver can confidently resolve all their eldercare issues.

N R: You mention 19 pitfalls. What are some of the common ones caregivers fall into?

B F: The first – and probably most important – is not understanding and respecting the generational and emotional differences between us Baby Boomers and our parents. The fact is that generational attitudes and emotional perspectives matter . . . a lot. But too often family members think that because we come from the same family we think the same way. That’s just not true! Our parent’s generation is very different from ours and understanding and respecting how they view the world and feel about it emotionally is critical to your success.

Sometimes what our parents say or do is illogical from our point of view but usually that’s because of their generational perspective. As a result, the way they see and feel about the world is very different from their Baby Boomer children, so it’s very important to understand and respect where they’re coming from both generationally and emotionally.

Another pitfall – and my biggest pet peeve – is thinking in terms of “parenting the parent”. If one person is the parent, by definition, the other is the child. The problem with that is that it’s then very easy to start treating and/or talking to your aging loved ones as if they are children – which they will quite rightfully resent. No one likes being condescended to . . . the “verbal pat on the head”. Unless they have dementia, the best you can do is work with them. Therefore, rather than approaching a conversation with your aging loved one as “parenting the parent”, approach it as a collaboration. And the key to a successful collaboration with your aging loved one is to create and maintain an “adult/adult” relationship.

Another biggie is thinking you can make anyone want to change. Bottom line . . . you can’t. You can’t with your kids, you can’t with your spouse – and with them you have more leverage! So if you try to make your aging loved one do something, it’s not surprising you won’t be successful. The fact is, what you think someone should do doesn’t matter. The only thing that matters is that the person making the change wants to make the change. So what do you do? You ask questions – the kind of questions that will help them discover their reason for doing something. The reason may not be your reason or it may be one you never thought of but if their reason works for them and the issue is resolved, then who cares?? (By the way – the same concept works on your kids and your spouse!)

There are 19 pitfalls that come with The Ultimate Caregiver’s Success System but these are major ones.

N R: Your company, AgeWiseLiving has been around for 10 years so what took you so long to write the book?

B F: Every person’s situation is unique to them so for a long time (ok . . . a very long time) I didn’t see how I could write something that would apply to everyone. But over time, I realized that, while each family is unique, the framework for resolving the issues is the same.

For example: Many people make a long list of their goals or have just one . . . such as to move their loved one into an assisted living community or nursing home. (I mean – after all . . . that’s where they’re going to end up eventually, right? I’ve actually had clients who have said that! And then they wonder why their loved one has stopped speaking to them! Hello!)

But, I say that’s not goal. It may be the “end up” solution but it’s not the goal. In my opinion there are 3 goals – and 3 goals only . . .
Goal #1 – that your loved one is safe
Goal #2 – that your loved one is as healthy as possible
Goal #3 – that your loved one is happy

If you focus on these three, the rest of the decisions will be a lot easier to make because then your determining questions are: Will this make him/her safe? Will this help maintain or improve his/her health? Will this make him/her happy? When you keep these three goals in mind, everything else that follows will be a lot easier.

N R:
When dealing with parents, sibling relationships can be very difficult. Any suggestions for how they can work together during this difficult and emotional time?

B F:
Many caregivers – especially women – find themselves doing all the work themselves because they don’t realize how much work it will be until they are overwhelmed and struggling. In addition, because of family dynamics, many caregivers think that it’s easier to go it alone than get involved with all the drama of the family issues. (One of the hardest things about eldercare is that it brings up all the “mommy & daddy” stuff and it can bring out the best and the worst in people.) And on top of that . . . the caregiver ends up really resenting her sibs for not doing what she never asked them to do in the first place!!!

There is a lot of information in The Ultimate Caregiver’s Success Guide but briefly, the solution as it relates to getting your family to help is to call the family together for a care planning meeting specifically called to create a care plan for your aging loved one.

N R: What is the biggest mistake eldercare givers make?

B F: There are two actually. The first is that they don’t organize, plan, and prepare in advance. When our parents were taking care of their parents, the average length of caregiving was 3-5 years. Now the average is 15 years. (My journey with my mother was 17 years.) That’s a long time. When it was only 3-5 years, caregivers might have been able to “wing it” for a few years but you can’t wing it for 15-20 years and stay sane!!! The point is . . . . you can’t always predict your eldercare issues – but you can prepare for them.

The second big mistake is not taking care of themselves. All eldercare givers seem to have one trait in common – that they take care of everyone else – especially their aging loved one – before they take care of themselves. But the reality is – if you don’t take care of yourself you’ll be no good to anyone else. And no, It’s not selfish or self serving to take care of yourself. It’s simply a matter of – if you want to help others – you have to help yourself first.

N R: Some of our readers may not have heard of a Generational Coach. Could you explain a little about Generational Coaching?

B F: As a Generational Coach I work with families who are struggling to help their aging loved ones resolve critical elder care issues. Not only do I help the families figure out what to do, I also help the family communicate effectively with their aging loved one so their aging loved one will actually do what’s in their best interest. In other words, I help families resolve their eldercare issues by choice, not crisis.

I work with the family members – never the senior – and all the work I do is by phone so I work with families all over the world. And, since sibling issues can be a big challenge for many families, I also help siblings work successfully together.

N R: How did you become a Generational Coach?

B F: I became a Generational Coach as a result of more than 25 years of personal experience. I was the care manager for many years for my grandmother and for the past 17 years for my mother who by the time she died recently, had severe advanced dementia.

Helping my grandmother was relatively easy because we were really close. With my mother, on the other hand, it wasn’t so easy because frankly, she and I weren’t all that close. But after my father died, my mother needed help and even though I have 2 other sisters, my mother would only let me help her – which I was happy to do.

Initially I took over her finances which was relatively easy because she wanted my help. Later though, when I had to take away the car and move her into an assisted living community it was extremely difficult and contentious. I realized that finding the answers and getting someone else to do what needs to be done were 2 very different things! I knew I had to figure out some way to talk with her so she would willingly do what was in her best interest – a way other than trial & error!!!

So I did a lot of research, talked with hundreds of seniors and their families, and professionals with senior clients – and created a system that helps the generations successfully help each other WITHOUT the time, money, and stress of trial and error – which ultimately became The Ultimate Caregiver’s Success System.

Thanks, Barbara, for your thoughtful and helpful answers to some difficult questions. You can learn more about Barbara and her work by clicking on the title of this post - it'll take you to her website, AgeWiseLiving.com.

Readers, now is your chance to find your voice. Click on "Comments" just below and to the right of this post. Share your concerns and ask Barbara your questions. Follow the prompts – you can sign on as anonymous and click send – it's as easy as that! And log on again tomorrow for our wrap-up. We'll be posting your comments, questions and Barbara's answers.

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21 Comments:

Anonymous Anonymous said...

I live in California and my mom is in her 80's and in Florida. How do I deal with the bad feelings when something comes up and I can't leave my kids and job to go help take care of it. Cynthia

7:27 AM  
Anonymous Anonymous said...

My Mother died last year and my Father now comes over all the time. She used to be the one to connect with my kids. We love being with him and it's so different - he's so emotionally available. What do you make of this?

7:44 AM  
Anonymous Anonymous said...

Barbara's Reply -

How lovely that your father visits all the time and that he’s so connected to you and your kids. That’s not always the case. Too often when the mother dies, the father becomes withdrawn because, like many men of his generation, the mother was the “family” person. His ‘new’ connection may be because he’s lonely. Or maybe he’s now getting to be the person he always was but his ‘role’ in the family didn’t allow him to be. Whatever the reason, what a wonderful gift you now have!

8:10 AM  
Anonymous Anonymous said...

Barbara writes

Hi Cynthia –
This is a difficult question to answer without more background on your Mom and what kinds of things you’re talking about. However, some things to think about . . .

Do things come up when she’s feeling neglected (eg: you haven’t called in a few days)? If that’s the case, you might want to set up regularly scheduled calls and include the kids on at least some of them. Encourage them (any you!) to tell her about all the things they’re doing so she can get a better idea of how busy everyone is.

Do things come up because of lack of planning on her part (eg: no one to take her to a doctor’s appointment she knew was on the calendar)? If so, “teach” her how to be more organized. For example – to make transportation arrangements when she makes the doctor’s appointment.

8:22 AM  
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8:36 AM  
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8:41 AM  
Anonymous Anonymous said...

Barbara, thank you for writing this book - so necessary today as you said, with so many of us caring for our elderly parents over a span of years. My mother-in-law has advanced Altzheimers. She mostly lives in her own world and recently has shown signs of not knowing who we are. Whereas I used to see her 3-4 times a week, I now see her maybe twice. I feel guilty not spending as much time, but as soon as I leave she forgets I was there. And unfortunately my stay leaves me feeling sad and empty.

9:47 AM  
Anonymous Anonymous said...

I was surprised when you said that you didn't get along with your mom and then you were able to take care of her for so long. I have what may be a similar situation. I know you can't tell me how you did it, but is there one thing that stands out about the changes you made? Sandy

10:19 AM  
Anonymous Anonymous said...

Barbara replies:

I know just how you feel! I used to go through the same thing with my mother. I don't know which is worse . . . the saddness or the guilt. The important thing to remember - in fact, perhaps the only thing to remember, is that it is not the quantity of time you spend with your mother-in-law but rather the quality of time. In addition, as the dementia progresses, what they respond to best is the sense of tough. So, while you're there, hold her hand, stroke her arm. She will remember that more than anything you say or how long you were there.

I also urge you to be gentle with yourself. Your visits - no matter how often or how long - are an act of love.

By the way, there are 2 newsletters on my website that may help. One is Heart to Heart (March 09) and the other is Why Bother Visiting Mom. You can find them both at http://agewiseliving.com/newsletters.htm

11:11 AM  
Anonymous Anonymous said...

Barbara replies:

I know just how you feel! I used to go through the same thing with my mother. I don't know which is worse . . . the saddness or the guilt. The important thing to remember - in fact, perhaps the only thing to remember, is that it is not the quantity of time you spend with your mother-in-law but rather the quality of time. In addition, as the dementia progresses, what they respond to best is the sense of touch. So, while you're there, hold her hand, stroke her arm. She will remember that more than anything you say or how long you were there.

I also urge you to be gentle with yourself. Your visits - no matter how often or how long - are an act of love.

By the way, there are 2 newsletters on my website that may help. One is Heart to Heart (March 09) and the other is Why Bother Visiting Mom. You can find them both at http://agewiseliving.com/newsletters.htm

11:20 AM  
Anonymous Anonymous said...

My elderly mother's memory is failing. Additionally, she has begun to lose weight. She cares for herself in her own home and does not want anyone to come in to help her. We (daughters) want to respect her choices, but are beginning to be worried re: her safety (e.g. possible stove fire, forgetting to eat due to lack of appetite, etc.). She feels we are overly concerned. Any thoughts on this? Thanks.

11:41 AM  
Anonymous Anonymous said...

Barbara's reply

Hi Sandy -

I am sorry you may have a similar situation. I think there are a lot of daughters who do! It was hard but I knew if I focused on the anger, I would not be able to help my mother the way I wanted to - or my insides would explode!

So I had a number of long conversations with myself and made the conscious decision to stop trying to get answers (or maybe even an apology) and focus on who she now was and how I could help her.

Because of my work, I knew that she made decisions based on the experiences of her life - some of which she may have been aware of, but a lot she probably wasn't. Therefore, whatever caused my feelings toward her, they probably would never be resolved with her. Also, once I realized that, because of her dementia, she would never be able to explain some of her actions or decisions as I was growing up, there was no point in dwelling on it. It may not have been the best way (and since my Mother's death in June, I have gotten help to deal with the anger) but that's what worked for me.

That is also why I wrote "The Ultimate Caregiver's Success Guide" - so that family members could help their loved one in an unemotional, yet very effective way. As a result they can make good decisions and provide care regardless of past history.

12:13 PM  
Anonymous Anonymous said...

Barbara's reply:

First let me say I don't think you're overly concerned. In fact, your Mom is lucky to have daughters who are concerned.

Your Mom's situation is very common. She doesn't want to give up her independence and, as a woman of her generation, her home and taking care of it is her identity. However, it sounds like she needs some help.

Because she is losing weight, I suggest she starts by getting a full medical check-up. (Be sure they check for a urinary tract infection - a common cause of increased forgetfulness.) To get her to accept help, you can also do a list of the pros and cons of her living alone at home. Then help her see that in order to stay in her own home, that she needs to address the cons (such as not eating properly, safety, etc) (You might also want to check out a CD I did called "Is It Simple Forgetfulness or the Real Thing" at http://agewiseliving.com/shop-simple_forgetfulness.htm)

1:58 PM  
Anonymous Anonymous said...

You mention taking care of the caregiver and I read that in a lot of articles. But I hardly ever manage that. Do you have any ideas about how to make that happen?

3:07 PM  
Anonymous Anonymous said...

When my parents were older and failing I was busy with family and work. Now that I'm getting up there and my kids don't have that much time for me, I finally realize how my parents must have felt. It's too bad that we often come to awareness when it's too late. Paola

3:40 PM  
Anonymous Anonymous said...

Barbara's reply -

I know what you mean! I was never too good at carving out time for myself either! It's not easy - especially for women who are taught that they are supposed to take care of everyone else before they take care of themselves. Unfortunately, after we take care of everyone else, there's not much time left for us!

One way to do it is to think of the saying "pay yourself first". In other words, schedule time for yourself before scheduling anyone else. (Yes, actually pen it into your calendar!) BTW - it's easier to stick to it if you schedule an activity such as going to the gym or a yoga class or meeting up with a friend for a walk. That way it's harder to back out. But even if you just take an hour every day to read a book , be sure to tell your family that this time is YOURS and you're not to be interrupted. And just keep telling yourself . . . "I'm worth it!"

4:32 PM  
Anonymous Anonymous said...

Barbara replied -

Hi Paola -

Ironic, isn't it? And kinda sad! You might want to mention the irony to your kids and see if they're willing to schedule something with you on a regular basis. It would be a shame for them to come to this realization when it's too late, too!

4:34 PM  
Anonymous Anonymous said...

Barbara, I really like what you said about not trying to parent our parents. It's so easy to fall into this trap - to think that we know so much more than they do and can make better decisions. Even though my parents are not as sharp as they used to be, they do still have wisdom and experience that I have not yet amassed. Thank you for bringing this up. I will try to remember it when I start trying to take over, be officious and usurp all the control - as I have certainly done before.
Paula

10:57 PM  
Anonymous Anonymous said...

My brother and I can't agree on the best course of action to take with my dad who is 88. Dad has been having so many problems, the doctors say they can do a dramatic procedure which will hurt his quality of life but give him more years. I think quality of life is more important and don't want the procedure done but my brother wants them to do it. How can we settle this?

7:28 AM  
Anonymous Anonymous said...

Well said, Paula!

9:16 AM  
Anonymous Anonymous said...

Barbara replied:

I have often said that sibling issues are more difficult to resolve than the parent issues!

I suggest you and your brother sit down and very calmly and analytically look at the impact of each of the approaches. For example - as your Dad's quality of life decreases, what will that mean for him? Will it mean more pain? Will it mean mobility difficulty - and to what extent? What kind of care will he require in the long term and how will that be accommodated?

Conversely, if he doesn't have the procedure, what will that mean for him? Will the above issues still come into play but just in a more condensed time frame? The point of the conversation isn't to puch either position but rather to calmly analyze what each course of action will mean for your father. Ideally, when the two lists are made, the decision will become clear.

By the way, has your father ever given any indication about what's important to him? Have either of you sat down with him and asked what he wants and then really listened? And not just to his current situation but also to any comments he may have made in the past about his family and how he may have felt about what they went through? He may be reluctant to pick either solution for himself but very often those casual comments about other people speaks volumes.

My thoughts are with you whichever way you all decide to go.

9:53 AM  

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